Private Yacht Marine Cargo Declaration

Vessel Information

Vessel Name IMO Number Flag Call Sign Port of Registry

Voyage Information

Port of Departure Port of Arrival Estimated Time of Arrival Estimated Time of Departure

Owner/Charterer Information

Owner/Charterer Name Contact Information

Cargo Details

Description of Cargo	Quantity	Unit	Weight	Remarks

Declaration

I hereby declare that the above information is correct to the best of my knowledge: Date